title: Are routine chest radiographs necessary after image-guided placement of internal jugular central venous access devices?
abstract: OBJECTIVE
  The purpose of this study was to determine the value and cost of obtaining routine chest radiographs after image-guided placement of internal jugular central venous catheters.
  
  
  METHODS
  We reviewed the records of 424 patients in whom 572 internal jugular catheters were placed by sonographic and fluoroscopic guidance over a 2-year period. Inspiratory and expiratory chest radiographs obtained immediately after each procedure were also reviewed.
  
  
  RESULTS
  Routine postprocedural chest radiographs revealed no complications and did not alter the treatment of any patient. Delayed pneumothorax was detected after placement of two catheters (0.5%) when patient symptoms prompted additional radiographs.
  
  
  CONCLUSIONS
  Immediate postprocedural chest radiographs are not routinely needed after image-guided insertion of internal jugular central venous catheters and unnecessarily add to the cost of patient care.
authors.affiliation: Department of Radiology, University of Chicago Hospitals, IL 60637, USA.
authors.forename: T C
authors.initials: TC
authors.lastname: Chang
authors.forename: B
authors.initials: B
authors.lastname: Funaki
authors.forename: G X
authors.initials: GX
authors.lastname: Szymski
mesh_terms: D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D006801:Humans; D007601:Jugular Veins; D006278:Medicare / Q000191:economics; D011030:Pneumothorax / Q000000981:diagnostic imaging / Q000209:etiology; D013902:Radiography, Thoracic / Q000191:economics* / Q000706:statistics & numerical data; D014481:United States